A Rule-Based Solution to Opaque Medical Billing in the U.S.

Patients and physicians do not know the cost of medical procedures. Opaque medical billing thus contributes to exorbitant, rising medical costs, burdening the healthcare system and individuals. After criticizing two proposed solutions to the problem of opaque medical billing, I argue that the Centers for Medicare and Medicaid Services should pursue a rule requiring that patients be informed by the physician of a reasonable out-of-pocket expense estimate for non-urgent procedures prior to services rendered.

Genetic disenhancement and xenotransplantation: diminishing pigs' capacity to experience suffering through genetic engineering.

One objection to xenotransplantation is that it will require the large-scale breeding, raising and killing of genetically modified pigs. The pigs will need to be raised in designated pathogen-free facilities and undergo a range of medical tests before having their organs removed and being euthanised. As a result, they will have significantly shortened life expectancies, will experience pain and suffering and be subject to a degree of social and environmental deprivation. To minimise the impact of these factors, we propose the following option for consideration-ethically defensible xenotransplantation should entail the use of genetic disenhancement if it becomes possible to do so and if that pain and suffering cannot be eliminated by other means. Despite not being a morally ideal 'solution', it is morally better to prevent unavoidable pain until a viable non-animal alternative becomes available.

Compassionate Conservation is indistinguishable from traditional forms of conservation in practice.

Animal welfare and ethics are important factors influencing wildlife conservation practice, and critics are increasingly challenging the underlying ethics and motivations supporting common conservation practices. "Compassionate Conservationists" argue that all conservationists should respect the rights of individual sentient animals and approach conservation problems from a position of compassion, and that doing so requires implementing practices that avoid direct harm to individual animals. In this way Compassionate Conservationists seek to contrast themselves with "Traditional Conservationists" who often express consequentialist decision-making processes that ostensibly aim to dispassionately minimize net animal harms, resulting in the common use of practices that directly harm or kill some animals. Conservationists and other observers might therefore conclude that the two sides of this debate are distinct and/or that their policy proscriptions produce different welfare outcomes for animals. To explore the validity of this conclusion we review the ethical philosophies underpinning two types of Compassionate Conservation-deontology and virtue ethics. Deontology focusses on animal rights or the moral duties or obligations of conservationists, whereas virtue ethics focusses on acting in ways that are virtuous or compassionate. We demonstrate that both types permit the intentional harm and killing of animals when faced with common conservation problems where animals will be harmed no matter what the conservationist does or does not do. We then describe the applied decision-making processes exhibited by Compassionate Conservationists (of both types) and Traditional Conservationists to show that they may each lead to the implementation of similar conservation practices (including lethal control) and produce similar outcomes for animals, despite the perceived differences in their ethical motivations. The widespread presence of wildlife conservation problems that cannot be resolved without causing at least some harm to some animals means that conservationists of all persuasions must routinely make trade-offs between the welfare of some animals over others. Compassionate Conservationists do this from an explicit position of animal rights and/or compassion, whereas Traditional Conservationists respect animal rights and exhibit this same compassion implicitly. These observations lead to the conclusion that Compassionate Conservation is indistinguishable from traditional forms of conservation in practice, and that the apparent disagreement among conservationists primarily concerns the effectiveness of various wildlife management practices at minimizing animal harm, and not the underlying ethics, motivations or morality of those practices.

Why appeals to the moral significance of birth are saddled with a dilemma.

In 'Dilemma for Appeals to the Moral Significance of Birth', we argued that a dilemma is faced by those who believe that birth is the event at which infanticide is ruled out. Those who reject the moral permissibility of infanticide by appeal to the moral significance of birth must either accept the moral permissibility of a late-term abortion for a non-therapeutic reason or not. If they accept it, they need to account for the strong intuition that her decision is wrong as well as deny the underlying normative principle that killing a viable fetus requires good reason, and not wanting to care for the child when the child could be easily placed for adoption is not a good enough reason to abort. If they reject the moral permissibility of the late-term abortion, they need to explain why her decision is wrong. Doing so, however, will undermine their own project of denying infanticide by appeal to birth. Walter Veit argues that the dilemma relies too much on intuition and does not live up to biological continuity. We explain why his criticisms are unconvincing.

A critical examination of the false hope harms argument.

Marleen Eijkholt presents a new argument in healthcare ethics, the false hope harms (FHH) argument. In brief, false hope promotes a host of individual harms (e.g., financial, physical, and psychological harms) and system-level harms (e.g., distrust of medical practitioners, increased complexity of care and the associated costs), all of which provide reason for healthcare providers to stop promoting false hope in medicine. The goal of this paper is to show that the FHH argument is unsuccessful.

Dilemma for appeals to the moral significance of birth.

Giubilini and Minerva argue that the permissibility of abortion entails the permissibility of infanticide. Proponents of what we refer to as the Birth Strategy claim that there is a morally significant difference brought about at birth that accounts for our strong intuition that killing newborns is morally impermissible. We argue that strategy does not account for the moral intuition that late-term, non-therapeutic abortions are morally impermissible. Advocates of the Birth Strategy must either judge non-therapeutic abortions as impermissible in the later stages of pregnancy or conclude that they are permissible on the basis of premises that are far less intuitively plausible than the opposite conclusion and its supporting premises.

Orphans and the relational significance of birth: a response to Singh.

Prabhpal Singh has defended a relational account of the difference in moral status between fetuses and newborns. Newborns stand in the parent-child relation while fetuses do not, and standing in the parent-child relationship brings with it higher moral status for newborns. Orphans pose a problem for this account because they do not stand in a parent-child relationship. I argue that Singh has not satisfactorily responded to the problem.